Mouthpiece and methods of use of same

ABSTRACT

Various embodiments of mouthpieces for use during endoscopic procedures are disclosed herein. According to various embodiments, a mouthpiece may include a shield, a primary instrument channel, a bite block, an oxygen administration channel and a tongue depressor. The shield, bite block, oxygen administration channel and tongue depressor may be integrally formed.

RELATED APPLICATIONS

The present application is a continuation of copending U.S. patentapplication Ser. No. 13/032,070, filed Feb. 22, 2011, titled “MOUTHPIECEAND METHODS OF USE OF SAME,” which claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application No. 61/338,665, filed Feb.22, 2010, titled “COMBINATION BITE BLOCK, ORAL AIRWAY, AND OXYGEN PORT,”the contents of each of which are incorporated herein by reference intheir entirety.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is an isometric view of one embodiment of a mouthpiece.

FIG. 1B is a rear view of the mouthpiece illustrated in FIG. 1A.

FIG. 1C is a front view of the mouthpiece illustrated in FIG. 1A.

FIG. 1D is a side view of the mouthpiece illustrated in FIG. 1A.

FIG. 1E is a cross-sectional view taken along the line 1E-1E of themouthpiece illustrated in FIG. 1B.

FIG. 2 is a cross-sectional view taken along the line 2-2 of themouthpiece illustrated in FIG. 1B.

FIG. 3 is a side view of one embodiment of a mouthpiece in a patient'smouth.

FIG. 4A is an isometric view of one embodiment of a mouthpiece.

FIG. 4B is a rear view of the mouthpiece of FIG. 4A.

FIG. 4C is a front view of the mouthpiece of FIG. 4A.

FIG. 4D is a side view of the mouthpiece of FIG. 4A.

FIG. 5 is a front view of one embodiment of a mouthpiece including anoxygen administration channel and a supplemental port.

FIG. 6A is a front view of one embodiment of a mouthpiece.

FIG. 6B is a rear view of the mouthpiece of FIG. 6A.

FIG. 6C is a side view of the mouthpiece of FIG. 6A.

FIG. 7 is a perspective view of one embodiment of a mouthpiece includinga strap that may be used to secure the mouthpiece during a medicalprocedure.

FIG. 8A illustrates a perspective view of one embodiment of a mouthpieceincluding an oxygen administration channel with a connector that isangled away from a primary instrument channel.

FIG. 8B illustrates a perspective view of one embodiment of a mouthpieceincluding an oxygen administration channel with an extension tube and aconnector that are angled away from a primary instrument channel.

DETAILED DESCRIPTION

Endoscopic procedures may be used to treat and diagnose a wide varietyof medical conditions. For example, bronchoscopy is a medical procedureused to diagnose and treat airway pathology. Conditions such aspneumonia, cancer, atelectasis, hemoptysis, and the presence of aforeign object may be diagnosed and/or treated by bronchoscopy. Further,upper endoscopy (also known as esophagogastroduodenoscopy or EGD) is aprocedure that enables a doctor to examine, diagnose, and treatconditions of the esophagus, stomach and duodenum (e.g., cancer, anulcer, the presence of a foreign object, inflammation).

In a bronchoscopy procedure, a bronchoscope is passed through thepatient's mouth, and then through the vocal cords into the trachea andbronchi. A patient undergoing bronchoscopy typically lies on his/herback for the procedure, a local anesthetic may be sprayed into thepatient's pharynx. A bite block may be placed into the patient's mouthto prevent damage to the scope or the patient's teeth. Bronchoscopy maybe accompanied by hypoxia (reduced content of oxygen in blood) and, lesscommonly, apnea (cessation of respiration).

Similarly, in an endoscopic procedure an endoscope is passed through thepatient's mouth and into the patient's upper gastrointestinal tract.During an endoscopic procedure, a doctor may perform biopsies, stopbleeding, remove a foreign object, and perform other tasks. As withbronchoscopy, endoscopy may be accompanied by hypoxia and, lesscommonly, apnea.

Various embodiments of mouthpieces disclosed herein provide a biteblock, an oxygen administration channel, a primary instrument channel,and a tongue depressor. The bite block may be used to keep a patient'smouth open during a procedure and to prevent damage to the patient'steeth or medical instruments that could be caused if the patient were tobite down on the medical instruments in the patient's mouth. Accordingto certain embodiments, apertures may be provided on one or both sidesof a bite block in order to allow for additional points of entry forinstruments into the patient's mouth.

Many bronchoscopic and endoscopic procedures are performed under generalanesthetic. When a patient is placed under general anesthetic, oxygen isfrequently administered. During a bronchoscopic or endoscopic procedure,oxygen may be administered via the oxygen administration channel inorder to reduce the risk of hypoxia. According to various embodiments,the oxygen administration channel may be configured to deliver oxygen tothe posterior pharynx. The tongue depressor may lift and hold the baseof the patient's tongue upward and forward (in a supine patient) toprovide improved airflow during the procedure.

Certain embodiments may also include a supplemental access port disposedon the opposite side of the mouthpiece from the oxygen administrationchannel. The supplemental access port may provide an additional point ofaccess for medical tools that may be used during a procedure. Forexample, the supplemental access port may allow for the use of a suctiontube.

According to various embodiments, a mouthpiece may be integrally formedand may be manufactured in a variety of sizes. Further, mouthpiecesaccording to the present disclosure may be provided in a variety ofsizes and configurations that are specifically adapted to patients ofdiffering sizes and various types of procedures. For example, in oneembodiment, the bite block, tongue blade, and oxygen channel may besized to accommodate an adult human oral cavity. Further, in anotherembodiment, the bite block, tongue blade, and oxygen channel havedimensions suitable for human pediatric use. In addition, certainembodiments may have dimensions and shapes suitable for use in non-humanmammals.

A primary instrument channel may be formed by the bite block, and theprimary instrument channel may have any shape suitable to accommodatemedical instruments that are used during a medical procedure. Forexample, the primary instrument channel may be square, rectangular, orovoid. According to certain embodiments, the oxygen administrationchannel may be located outside of the primary instrument channel. Suchembodiments may maximize the area available for insertion of medicalinstruments through the patient's mouth and into the patient'srespiratory tract or upper gastrointestinal tract. Further, the oxygenadministration channel may be positioned with respect to the bite blocksuch that contact between a patient's teeth and the bite block preventcontact between the oxygen administration channel and the patient'steeth.

FIGS. 1A-1E illustrate various views of one embodiment of a mouthpiece100. Mouthpiece 100 includes a bite block 110, a shield 120, apertures130 and 132, an oxygen administration channel 140, a tongue depressor150, and a primary instrument channel 160. Shield 120 contacts the faceand lips of the patient. Bite block 110 is disposed on the posteriorside of shield 120. A tongue depressor 150 is also disposed on theposterior and bottom side of bite block 110. Anchors 122 and 124 aredisposed on the sides of shield 120. Anchors 122 and 124 are illustratedas “T” shaped. A strap (not shown) can be attached to anchors 122 and124. The strap may be placed around the back of a patient's head tosecure mouthpiece 100 during a procedure. In alternative embodiments,anchors 122 and 124 may be ring shaped and may allow straps to passthrough. Furthermore, anchors 122 and 124 may be shaped as slidebuckles.

During a procedure, bite block 110 may be positioned such that apatient's teeth and lips are situated between shield 120 and flange 112.Flange 112 may help to prevent mouthpiece 100 from coming out of apatient's mouth during a procedure. Bite block 110 may be configured topermit ease of use and a comfortable fit on the patient. The shield 120can be made of any material rigid enough to maintain its shape andwithstand repeated sterilizations but can also be flexible enough toallow the mouthpiece 100 to bend for the patient's comfort.

Bite block 110 may be made of a material that is rigid enough to keepits shape, and strong enough to withstand without significantdeformation from the pressure exerted if the patient bites hard on thebite block 110; however, the material used in the construction of biteblock 110 may be soft enough to avoid damage to the patient's teeth.According to some embodiments, a padded collar may be placed around thebite block 110 to provide a softer material for the teeth to contact.According to one embodiment, the material used in the construction ofmouthpiece 100 may have a durometer hardness of between 30 Shore A to 65Shore D.

According to certain embodiments, bite block 110 and other components ofmouthpiece 100 may be formed from a variety of materials includingpolyurethane, polypropylene, polyethylene, silicone, and ABS(acrylonitrile-butadiene-styrene). According to one particularembodiment, a dual injection fabrication technique may be used.Santoprene may be used in connection with such embodiments. Mixtures andblends of the polymers listed above and similar polymers may be used toform a mouthpiece having desired properties. Further, variousembodiments may utilize latex free materials and manufacturingprocesses. A hydrophilic coating may be used on one or more portions ofthe device.

As illustrated, oxygen administration channel 140 may be disposedadjacent to bite block 110 and outside of primary instrument channel160. Placement of oxygen administration channel 140 adjacent to biteblock 110 protects oxygen administration channel 140 from damage thatcould be caused if the patient were to bite down on oxygenadministration channel 140. Further, by placing oxygen administrationchannel 140 outside of primary instrument channel 160, more space may beprovided for medical instruments in primary instrument channel 160.

Oxygen administration channel 140 includes a forward end extending fromthe anterior end of shield 120 and configured to engage oxygen tubingusing a connector 142. As illustrated in FIG. 1A, connector 142comprises a pressure connector. In alternative embodiments, a connectormay be embodied as a luer lock. Connector 142 may provide an air-tightseal and may be used to provide oxygen to a patient.

Oxygen administration channel 140 may include a tube 144 that extendsalong at least a portion of the length of tongue depressor 150.According to alternative embodiments, the length of tube 144 may varywith respect to tongue depressor 150 (e.g., in some embodiments, tube144 may be shorter, longer, or of approximately the same length, astongue depressor 150). According to one particular embodiment, tube 144may extend beyond the length of tongue depressor 150 and may bepositioned near the trachea. In this position, tube 144 may be used toprovide jet ventilation. In one embodiment in which tube 144 extendsbeyond tongue depressor 150, an attachment of a desired length may beconnected to tube 144. The diameter of tube 144 and connector 142 may besuch that a sufficient volume of gas can be provided to supplement thepatient's respiration. In addition, oxygen administration channel 140may provide a route for topical administration of anesthesia to apatient's pharyngeal region. According to one embodiment, connector 142may be formed of a rigid material that allows connector 142 to properlyengage the tubing, while at least of portion of tube 144 is formed of amore flexible material that allows tube 144 to enter the patient'spharynx. Tube 144 and connector 142 may be circular or oblong (e.g.,partially flattened in one dimension) in cross-section.

Tongue depressor 150 may be substantially rigid and have a downwardcurve that is configured to depress the patient's tongue. Further,tongue depressor 150 may act as a guide for instruments inserted throughprimary instrument channel 160. Tongue depressor 150 may prevent theretraction of the forward portion of the patient's tongue, which couldcause a blockage of the patient's airway. Tongue depressor 150 may havea width such that it fits between the rear teeth of the patient.According to various embodiments, mouthpiece 100 may be color-codedbased on the size of tongue depressor 150, according to standard colorschemes used for oral airways according to the length of tonguedepressor 150.

According to certain embodiments, tongue depressor 150 may beimpregnated with a local anesthetic. Further, the local anesthetic couldbe slowly released over a period time. The period of time may correspondto an anticipated length of time required for a medical procedureinvolving mouthpiece 100.

Mouthpiece 100 may be used in connection with a method for performingendoscopy, which includes the steps of inserting mouthpiece 100 into apatient's oral cavity; administering oxygen through oxygenadministration channel 140; and passing an endoscope (not shown) throughprimary instrument channel 160. Further steps may include administeringtopical anesthesia to the patient through oxygen administration channel140 or through a supplemental access port (not shown).

Mouthpiece 100 may also be used in connection with a method forperforming bronchoscopy, which includes inserting mouthpiece 100 into apatient's oral cavity; administering oxygen through the oxygenadministration channel 140; and passing a bronchoscope (not shown)through primary instrument channel 160. Further steps may includeadministering topical anesthesia to the patient through oxygenadministration channel 140 or through a supplemental access port (notshown).

According to various embodiments, primary instrument channel 160 may beat least partially defined by shield 120 and by bite block 110. Primaryinstrument channel 160 may be configured in a variety of shapes. In theembodiment illustrated in FIGS. 1A-1D, primary instrument channel 160 isapproximately square-shaped with rounded corners. In other embodiments,primary instrument channel 160 may be round, oval, elliptical,rectangular, etc.

FIGS. 1B and 1C illustrate mouthpiece 100 from a rear perspective and afront perspective, respectively. As illustrated in these figures,primary instrument channel 160 extends through shield 122 and bite block110 to allow the passage of instruments into the patient's pharynx.Primary instrument channel 160 may have a size and shape thatfacilitates the passage of instruments used in endoscopic andbronchoscopic procedures. A range of sizes may be offered to accommodatepatients of different sizes (e.g., a smaller size for a child and alarger size for an adult). The size of primary instrument channel 160may be given in terms of a diameter or width 162, or may be given on theFrench scale, where the French gauge is equal to 3 times diameter 162,as shown in Eq. 1.

French Gauge=Diameter (mm)×3   Eq. 1

According to one embodiment, primary instrument channel 160 may bebetween 40 French and 84 French (13.33 mm and 28 mm). According toanother embodiment, primary instrument channel 160 may be between 50French and 65 French (16.67 mm and 21.67 mm). Finally, according to yetanother embodiment, primary instrument channel 160 may be approximately60 French (20 mm).

Shield 120 may define apertures 130 and 132, which may provideadditional areas of access to a patient's mouth. In the illustratedembodiment, oxygen administration channel 140 is disposed in aperture130; however, additional area in aperture 130 is available for access tothe patient's mouth. Apertures 130 and 132 may be used to introduce asuction tube or other instrument into a patient's mouth. Apertures 130and 132 may be formed in any desired shape. In the illustratedembodiment, apertures 130 and 132 are approximately trapezoidal withrounded corners.

FIG. 1D illustrates a side view of mouthpiece 100. As illustrated inFIG. 1D, bite block 110 is significantly thicker than shield 120.According to one embodiment, bite block 110 may be between 5 and 10times thicker than shield 120.

As discussed above, mouthpiece 100 may be integrally formed.Accordingly, for a given material used to form shield 120 and bite block110, shield 120 may have greater flexibility due to its reducedthickness, and bite block 110 may have increased rigidity due to itsincreased thickness. The thickness of shield may be selected such thatshield 120 is sufficiently rigid to provide support for a strap (notshown) while being flexible for improved patient comfort.

FIG. 1D also illustrates that tongue depressor 150 has a length 152.Various embodiments may include a variety of lengths 152. As illustratedin FIG. 1D, the length of tongue depressor 150 is measured from theposterior side of bite block 110. Length 152 may be adapted based on apatient's age (e.g., adult or child) and/or size (small, medium, orlarge). According to one embodiment, length 152 may be between 40 and140 mm. According to another embodiment, length 152 may be between 90and 120 mm. Finally, according to yet another embodiment, length 152 maybe approximately 110 mm.

As illustrated in FIGS. 1A-1D, the center of shield 120, the center ofbite block 110, and the center of primary instrument channel 160 all liealong the same axis. While a coaxial arrangement is illustrated,according to various embodiments, the centers of one or more of shield120, bite block 110 and primary instrument channel 160 may not becoaxial.

FIG. 1E is a cross sectional view taken along line 1E-1E in FIG. 1B. Asillustrated in FIG. 1E, tongue depressor 150 may have a shallow C-shapedcross-section at least along a portion of its length, such that theshape of tongue depressor 150 approximately matches the curvature of thepatient's tongue.

FIG. 2 illustrates a cross-sectional view of mouthpiece 100 taken alongline 2-2 in FIG. 1B. FIG. 2 illustrates an embodiment in whichmouthpiece 100 is a unitary structure. In other words, individualcomponents that comprise mouthpiece 100 are integrally formed from asingle piece of material. The embodiment illustrated in FIG. 2 showsvarious integrally formed components of mouthpiece 100, including biteblock 110, flange 112, shield 120, anchor 122, and tongue depressor 150.Further, primary instrument channel 160 and aperture 132 are also formedby the unitary structure. As an all-in-one device, mouthpiece 100 doesnot present a risk of dislodgment of any individual component.

FIG. 3 illustrates a view of one embodiment of a mouthpiece 300 in apatient's mouth. As illustrated, a bite block 310 may be in contact withthe patient's teeth and may prevent the patient from biting down onmedical instruments inserted into the patient's mouth during aprocedure. A shield 320 is disposed against the exterior of thepatient's mouth. In embodiments including a flange (not shown), theflange may be positioned behind the patient's teeth.

Mouthpiece 300 also includes an oxygen administration channel 340 and atongue depressor 350. Oxygen administration channel 340 includes aconnector 342 and a tube 344. Oxygen administration channel 340 may bepositioned to deliver oxygen to the patient's pharyngeal area. Tonguedepressor 350 may be configured to prevent the retraction of the forwardportion of the patient's tongue, which could cause a blockage of thepatient's airway. Tongue depressor 350 may have a width such that itfits between the rear teeth of the patient. Mouthpiece 300 may alsoinclude a primary instrument channel 360 through which medicalinstruments may be inserted into the patient's mouth.

FIGS. 4A-4D illustrate various views of an embodiment of a mouthpiece400 that includes an oxygen administration channel 440 that is attachedto a tongue depressor 450 and integral with a portion of a bite block410. Mouthpiece 400 includes many features that are similar to thefeatures illustrated in FIGS. 1A-1 E and described above, including abite block 410, a flange 412, a shield 420, a connector 442, a tube 444,anchors 422 and 424, and apertures 430 and 432.

As illustrated in FIG. 4A, tube 444 is partially integrated into biteblock 410. At the intersection of tube 444 and bite block 410, flange412 is not present. Such a configuration may allow for additional accessto a patient's mouth using aperture 430 while minimizing the amount ofspace utilized by oxygen administration channel 440 in a primaryinstrument channel 460.

FIGS. 4B and 4D illustrate that tube 444 is integrally formed withtongue depressor 450, and show that in the illustrated embodiment,tongue depressor 450 is longer than tube 444. According to alternativeembodiments, the length of tube 444 may vary with respect to tonguedepressor 450 (e.g., in some embodiments, tube 444 may be shorter,longer, or of approximately the same length, as tongue depressor 450).

FIG. 4C illustrates a front view of mouthpiece 400. As described above,oxygen administration channel 440 is partially integrated with biteblock 410; however, only a small amount of space is used by oxygenadministration channel 440 in primary instrument channel 460.

FIG. 5 illustrates a front view of one embodiment of a mouthpiece 500that includes an oxygen administration channel 540 and a supplementalport 546. Mouthpiece 500 includes many features that are similar to thefeatures illustrated in FIGS. 1A-1E as described above, including ashield 520, anchors 522 and 524, apertures 530 and 532, and an oxygenadministration channel 540 that includes a connector 542. Mouthpiece 500also includes a supplemental port 546. Supplemental port 546 may be usedfor a variety of functions, including providing suction in a patient'smouth, application of topical anesthetic, or introduction of medicalinstruments into the patient's mouth. In one embodiment, supplementalport 546 may be manipulated into different positions. In anotherembodiment, supplemental port 546 remains stationary. Further,supplemental port 546 may be used to nebulize a local anesthetic.

FIG. 6A illustrates a front view of one embodiment of a mouthpiece 600.Mouthpiece 600 includes a shield 620 that contacts the face and lips ofthe patient. On the posterior side of the shield 620 is disposed a biteblock 610, as shown in FIG. 6B. Anchors 622 and 624 are disposed on thesides of shield 620. An oxygen administration channel 640 is alsodisposed on one side of shield 620 and bite block 610. Oxygenadministration channel may comprise a connector 642 and a tube 644.Shield 620 and bite block 610 each at least partially define a primaryinstrument channel 660 through which medical instruments may be insertedinto a patient's mouth. FIGS. 6A and 6B illustrate mouthpiece 600 ashaving a square shape. Shield 620, according to various embodiments, maybe made of any material that is sufficiently rigid to maintain its shapeand withstand repeated sterilizations while remaining sufficientlyflexible, in order to allow mouthpiece 100 to bend for the patient'scomfort.

FIG. 6C illustrates a side view of mouthpiece 600. Bite block 610extends from the posterior side of shield 620. Tongue depressor 650extends rearward from the bottom of bite block 610. Tongue depressor 650may include a shallow C-shaped cross-section along the contour of thetongue that provides a smooth transition from the square edge of biteblock 610. Tongue depressor 650 may be substantially rigid and may havea downward curve that is configured to depress the patient's tongue andact as a guide for instruments inserted through primary instrumentchannel 660.

Oxygen administration channel 640 is disposed on one side of bite block610. Oxygen administration channel 640 includes a connector 642 that isconfigured to engage with tubing. A tube may be in communication withconnector 642 and may direct a flow of oxygen toward the pharynx of thepatient.

FIG. 7 is a perspective view of one embodiment of a mouthpiece 700including a strap 770. Strap 770 may be placed around the back of auser's head in order to secure mouthpiece 700 during a medicalprocedure. Strap 770 includes a plurality of holes 772 that may be usedto secure strap 770 to anchors 722 and 724. The plurality of holes 772may facilitate adjusting the strap based on the size of the patient'shead. Strap 700 may be relatively wide for the patient's comfort and toavoid entanglement of the patient's hair and the strap 770. According toalternative embodiments, quick-release latches may be used in place ofanchors 722 and 724. In addition to anchors and quick-release latches,other types of strap securing elements may be provided. According tovarious embodiments, strap 770 may be latex free.

FIG. 8A illustrates a perspective view of one embodiment of a mouthpiece800 including an oxygen administration channel 840 with a connector 842that is angled away from a primary instrument channel 860. As discussedabove, one or more medical instruments may be inserted into a patient'smouth through primary instrument channel 860. Further, a doctor maymanipulate the instruments in order to complete the procedure. The areaaround primary instrument channel 860 may become crowded, andaccordingly, it may be desirable to angle connector 842 away fromprimary instrument channel 860. Angling connector 842 away from primaryinstrument channel 860 may help to prevent entanglement of an oxygentube (not shown) with medical instruments (not shown) being used ormanipulated during a medical procedure.

Mouthpiece 800 allows for an oxygen tube (not shown) to be connectedfrom the side, such that the tube is moved away from primary instrumentchannel 860. Oxygen administration channel also includes an elbow 846that is connected to a tube 844. According to various embodiments, elbow846 may have an angle between approximately 30° and approximately 90°.As illustrated in FIG. 8A, elbow 846 and connector 842 may be integrallyformed with other components of mouthpiece 800 in order to create aunitary structure. Mouthpiece 800 may also include many additionalfeatures that are similar to the features illustrated in FIGS. 1A-1E andthat are described above, including a bite block 810, a flange 812, ashield 820, anchors 822 and 824, a tongue depressor 850, and apertures830 and 832.

FIG. 8B illustrates a perspective view of mouthpiece 800, as illustratedin FIG. 8A, with the addition of an extension tube 848 disposed betweenelbow 846 and connector 842. Extension tube 848 may allow for connector842 to be extended a desired distance from primary instrument channel860. Providing additional distance between connector 842 and primaryinstrument channel 860 may help to prevent entanglement of an oxygentube (not shown) with medical instruments (not shown) being used ormanipulated during a medical procedure. Although FIG. 8B illustratesextension tube 848 being integrally formed with tube 844, elbow 846, andconnector 842, according to alternative embodiments, extension tube 848and/or connector 842 may be bonded to mouthpiece 800.

Many changes may be made to the details of the above-describedembodiments without departing from the underlying principles of thepresent disclosure. The scope of the present invention should,therefore, be determined only by the following claims.

1. A mouthpiece configured to be inserted into a patient's mouth duringa medical procedure, the mouthpiece comprising: a shield configured tocontact at least a portion of the patient's face; a primary instrumentchannel at least partially defined by the shield; a bite block at leastpartially defining the primary instrument channel, the bite blockconfigured to contact the patient's teeth and to maintain the patient'smouth in an open position during the medical procedure, the bite blockcomprising an oxygen administration channel that extends as a straighttube, such that contact between the bite block and the patient's teethprevents contact between the oxygen administration channel and thepatient's teeth; and a tongue depressor comprising a straight portionextending from a bottom of the bite block followed by a curved portion,wherein the oxygen administration channel extends parallel and adjacentto the straight portion of the tongue depressor; wherein the shield, thebite block, the oxygen administration channel, and the tongue depressorare integrally formed.
 2. The mouthpiece of claim 1, wherein the primaryinstrument channel comprises an opening between 50 French gauge and 65French gauge.
 3. The mouthpiece of claim 1, wherein at least a portionof the mouthpiece comprises a hydrophilic coating.
 4. The mouthpiece ofclaim 1, wherein the bite block has a durometer hardness of between 30shore A and 65 shore D.
 5. The mouthpiece of claim 1, wherein the oxygenadministration channel ends prior to the curved portion of the tonguedepressor.
 6. The mouthpiece of claim 1, wherein at least a portion ofthe tongue depressor comprises a shallow C-shaped cross-section.
 7. Themouthpiece of claim 1, wherein the oxygen administration channel iscompletely disposed outside of the primary instrument channel.
 8. Themouthpiece of claim 1, wherein the oxygen administration channel is atleast partially disposed outside of the primary instrument channel. 9.The mouthpiece of claim 1, wherein the shield defines a first aperture.10. The mouthpiece of claim 9, wherein the shield further defines asecond aperture and a supplemental access port extends through thesecond aperture.
 11. The mouthpiece of claim 1 wherein the bite blockfurther comprises a flange disposed at least partially around itsperimeter and configured to be positioned behind the patient's teethduring the medical procedure.
 12. The mouthpiece of claim 1, wherein alength of the tongue depressor is between 40 mm and 140 mm.
 13. Themouthpiece of claim 1, wherein a length of the tongue depressor isbetween 90 mm and 120 mm.
 14. The mouthpiece of claim 1, furthercomprising a plurality of strap securing elements disposed on oppositesides of the mouthpiece and configured to secure a strap to themouthpiece.
 15. The mouthpiece of claim 1, wherein the mouthpiececomprises at least one of polyurethane, polypropylene, polyethylene,silicone, ABS, and santoprene.
 16. A mouthpiece configured to beinserted into a patient's mouth during a medical procedure, themouthpiece comprising: a shield configured to contact at least a portionof the patient's face, the shield defining an aperture; a primaryinstrument channel at least partially defined by the shield; a biteblock at least partially defining the primary instrument channel, thebite block configured to contact the patient's teeth and to maintain thepatient's mouth in an open position during the medical procedure, thebite block comprising an oxygen administration channel that extends as astraight tube, wherein the oxygen administration channel is completelydisposed outside of the primary instrument channel, such that contactbetween the bite block and the patient's teeth prevents contact betweenthe oxygen administration channel and the patient's teeth; a tonguedepressor comprising a straight portion extending from the bite blockfollowed by a curved portion, wherein the oxygen administration channelextends parallel and adjacent to the straight portion of the tonguedepressor; and wherein the shield, the bite block, the oxygenadministration channel, and the tongue depressor are integrally formed.17. The mouthpiece of claim 16, wherein a portion of the oxygenadministration channel is formed of a flexible material.
 18. A methodfor performing a medical procedure, comprising: inserting a mouthpieceinto a patient's mouth; depressing a tongue of the patient with a curvedportion of a tongue depressor of the mouthpiece; preventing contactbetween the patient's teeth and an oxygen administration channel with abite block of the mouthpiece; administering oxygen through the oxygenadministration channel at the back of the mouth; and passing one of abronchoscope or an endoscope through a primary instrument channel atleast partially defined by the bite block.
 19. The method of claim 18,further comprising: administering topical anesthesia to the patientthrough the oxygen administration channel.
 20. The method of claim 18,further comprising: administering topical anesthesia to the patientthrough a supplemental access port while oxygen is administered throughthe oxygen administration channel.